Provider Demographics
NPI:1598840118
Name:HAYDN G. JONES II DDS PA
Entity Type:Organization
Organization Name:HAYDN G. JONES II DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAYDN
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-333-6714
Mailing Address - Street 1:1816 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5826
Mailing Address - Country:US
Mailing Address - Phone:704-333-6714
Mailing Address - Fax:704-334-3644
Practice Address - Street 1:1816 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5826
Practice Address - Country:US
Practice Address - Phone:704-333-6714
Practice Address - Fax:704-334-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC94708OtherBC/BS NC
NC8994708Medicaid